Course and prognosis of recovery for chronic non-specific low back pain: design, therapy program and baseline data of a prospective cohort study

Abstract

BackgroundThere has been increasing focus on factors predicting the development of chronic musculoskeletal disorders. For patients already experiencing chronic non-specific low back pain it is also relevant to investigate which prognostic factors predict recovery. We present the design of a cohort study that aims to determine the course and prognostic factors for recovery in patients with chronic non-specific low back pain.Methods/DesignAll participating patients were recruited (Jan 2003-Dec 2008) from the same rehabilitation centre and were evaluated by means of (postal) questionnaires and physical examinations at baseline, during the 2-month therapy program, and at 5 and 12 months after start of therapy. The therapy protocol at the rehabilitation centre used a bio-psychosocial approach to stimulate patients to adopt adequate (movement) behaviour aimed at physical and functional recovery. The program is part of regular care and consists of 16 sessions of 3 hours each, over an 8-week period (in total 48 hours), followed by a 3-month self-management program. The primary outcomes are low back pain intensity, disability, quality of life, patient's global perceived effect of recovery, and participation in work. Baseline characteristics include information on socio-demographics, low back pain, employment status, and additional clinical items status such as fatigue, duration of activities, and fear of kinesiophobia. Prognostic variables are determined for recovery at short-term (5 months) and long-term (12 months) follow-up after start of therapy.DiscussionIn a routine clinical setting it is important to provide patients suffering from chronic non-specific low back pain with adequate information about the prognosis of their complaint.

Prognosis and course of work-participation in patients with chronic non-specific low back pain: A 12-month follow-up cohort study

“…The outcome work-participation is 1 of the 5 outcomes (back pain intensity, disability due to back pain, work-participation, quality of life and patients' perceived recovery) measured in this prospective cohort. For all the outcomes the same 23 prognostic factors were included (7). BMI was changed into a categorical variable.…”

“…The study protocol was approved by the medical ethics committee of the SJC and all patients provided informed consent. Details of the study design are described elsewhere (7). All patients with CNSLBP were recruited between January 2003 and December 2008 at the SJC.…”

“…Patients were coached by a multidisciplinary team (e.g. a physical therapist, physician, health scientist, psychologist) (7).…”

“…The outcome was work-participation, which was defined by dividing "current work hours" by "former work employment hours" prior to CNSLBP (7). Recovery of work-participation was operationalized according to the following definition: absolute work-participation, defined as ≥ 90% work-participation at follow-up (11)(12)(13).…”

The Impact of Buprenorphine Transdermal Delivery System on Activities of Daily Living Among Patients With Chronic Low Back Pain

“…6 The symptoms of CLBP, particularly pain, can interfere with the ability to perform basic ADLs such as walking, sitting, standing, sleeping, and lifting. 7,8 Patients with CLBP have a lower level of daily physical activities compared with nonsymptomatic controls. 9 A recent literature review concluded that the effect of CLBP on a patient's ability to perform ADLs can also vary by factors other than symptoms, such as sex, self-efficacy, and fear of movement or reinjury.…”